Binge eating disorder is considered the most common eating and feeding disorder in the United States, affecting about 3% of Americans—three times more common than anorexia and bulimia combined.
Binge eating disorder is diagnosed primarily through a discussion and evaluation of symptoms, but can involve physical examinations and diagnostic testing.
This article covers how binge eating disorder is diagnosed.
Professional Screenings
The process for determining if a person has binge eating disorder usually begins with a primary healthcare provider. The provider will use a number of tools to make a diagnosis and determine next steps.
DSM-5 Criteria
Binge eating disorder began to be recognized as a unique disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
To be diagnosed with binge eating disorder, a person must meet the following criteria:
1 . Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
Eating, in a discrete period of time (e. g. , within any two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstancesThe sense of lack of control over eating during the episode (e. g. , a feeling that one cannot stop eating or control what or how much one is eating)
2 . Binge-eating episodes are associated with three (or more) of the following:
Eating much more rapidly than normalEating until feeling uncomfortably fullEating large amounts of food when not feeling physically hungryEating alone because of being embarrassed by how much one is eatingFeeling disgusted with oneself, depressed, or very guilty after overeating
3 . Marked distress regarding binge eating is present.
4 . The binge eating occurs, on average, at least one day a week for three months.
5 . The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.
In plainer terms, this means a person with binge eating disorder:
Mild: 1 to 3 episodes per weekModerate: 4 to 7 episodes per weekSevere: 8 to 13 episodes per weekExtreme: 14 or more episodes per week
Eats a large amount of food in a short amount of time, at least once a week for three months Feels out of control of their eating during the episodes Feels distressed about their binge-eating behavior Experiences at least three of the following: Eating very quickly; eating to the point of being uncomfortable; eating a lot of food while not hungry; embarrassment about the amount they are eating; feeling guilty or negatively about themselves after overeating Doesn’t do things to compensate for overeating such as purging or fasting, or only binge-eat as part of anorexia or bulimia
Physical Examination
While binge eating disorder is primarily diagnosed by a person’s descriptions of their symptoms, there are a number of reasons a healthcare provider may do a physical examination.
People with binge eating disorder are not necessarily obese, and people who are obese do not necessarily have binge eating disorder. About half of people with binge eating disorder are considered obese.
It is impossible to determine if someone has binge eating disorder simply from their body shape, and the health complications from binge eating are not always obvious at a glance.
Health complications caused by binge eating disorder a healthcare provider might look for include:
Diabetes High blood pressure High cholesterol Heart disease and stroke Certain cancers Gallbladder disease Depression, anxiety, and other mood disorders
A physical health exam may also involve:
Getting a medical history, including mental healthDiscussing family medical history, including eating disorders, mental health disorders, or substance use disordersReviewing symptoms or concernsNoting current medications being takenCalculating height and weightChecking vital signs (such as heart rate, blood pressure, and temperature)Examining skin and nailsListening to the heart and lungsFeeling the abdomenAsking about diet and eating habits, as well as compensatory behaviors such as self-induced vomiting, over-exercising, and fastingDiscussing substance use
If necessary, a primary healthcare provider may give a referral to a mental health professional for further screening and/or treatment.
Labs and Tests
There are no tests used specifically for diagnosing binge eating disorder. If a healthcare provider orders lab work or testing, it is usually for the purpose of checking the person’s general health or for conditions that may have developed from or been made worse by binge eating disorder.
They also feel that they are not in control of their eating, versus someone who is overeating simply because they are enjoying their meal.
These tests might include:
Blood tests Urine tests X-rays Ultrasound Electrocardiogram (ECG)
Self/At-Home Testing
While not a substitute for a professional assessment, there are at-home screening tools that can help determine if binge eating disorder is likely and if an appointment with a healthcare provider should be made to discuss further.
A 2019 study highlighted the need for more research into how eating disorders present in men, and how they can be better diagnosed and treated by healthcare providers.
PsyCom has an online questionnaire that involves answering questions with a rating on a scale from “never” to “very often.” Once the test is completed, it is submitted with one click for an instant result calculation.
Mind Diagnostics offers a similar online test.
The National Eating Disorders Association has a more indepth online questionnaire used to determine if someone has or is at risk for an eating disorder.
If any of these tools indicate you may be experiencing binge eating disorder, book an appointment to discuss your symptoms with a healthcare provider.
Summary
Binge eating disorder is diagnosed primarily through a discussion and evaluation of symptoms, but can involve physical examinations and diagnostic testing.
For more mental health resources, see our National Helpline Database.
A Word From Verywell
While binge eating disorder is the most common eating and feeding disorder in the United States, it is still not well understood.
Criteria for diagnosing binge eating disorder may seem unclear to you. If your eating behavior and your feelings surrounding food and eating are negatively impacting you, see your healthcare provider, even if you don’t appear to meet the formal criteria for binge eating disorder.
Binge eating disorder can be managed, and getting a diagnosis is the first step.
